British X-Factor judge, Cheryl Cole, comes down with malaria

Cheryl Cole, British singer and judge on Simon Cowell’s British version of “The X-Factor,” has been hospitalized in London with malaria. The 27- year-old performer had recently returned from a trip to Tanzania. She reportedly collapsed Saturday during a photo shoot for her new album. Her representative has reported that she has canceled all work this week. The singer/TV personality first came to notice in 2002 as part of the British pop group, Girls Aloud. In 2008 she became a judge on The X-Factor and most recently became the new face of L’Oreal. She is also scheduled as the opening act for some of the European dates of the Black Eyed Peas’ E.N.D. World Tour.

What is Malaria?

Malaria is an infectious disease caused by a single celled parasite, called plasmodium, that’s transmitted by mosquitoes. Although there are many varieties of plasmodium, only four cause disease in humans: P. falciprium, P. vivax, P. malariae, and P. ovale. Malaria has pretty much been eliminated in the United States and other temperate climates but remains a major health threat in tropical and subtropical countries in Africa, Asia, the Middle East, and South and Central America. P. falciprium is the most  predominant strain in Africa, produces the most severe symptoms and is responsible for most malaria deaths.

How is Malaria Spread?

The malaria parasite life cycle involves two hosts- female Anopheles mosquitoes, and humans. During a blood meal, a malaria-infected mosquito inoculates an immature form of plasmodium, called sporozoites, into the human host. The sporozoites infect liver cells, mature and rupture the liver cells, releasing daughter cells called merozoites into the bloodstream where they are taken up into red blood cells. (Of note, in P. vivax and P. ovale a dormant stage can persist in the liver and cause relapses by invading the bloodstream weeks, or even years later.) The parasites multiply in the red blood cells. It is in this blood stage that the clinical manifestations of the disease are seen. If another female Anopheles mosquito bites the infected person, it receives the parasite, which begins to multiply and eventually winds up in the salivary glands of the mosquito, ready to be injected into a new human host.

What are the symptoms of Malaria?

The classical (but rarely observed) malaria attack lasts 6-10 hours. It consists of

  • a cold stage (sensation of cold, shivering)
  • a hot stage (fever, headaches, vomiting; seizures in young children)
  • and finally a sweating stage (sweats, return to normal temperature, tiredness).

The attacks occur every second day with the “tertian” parasites (P. falciparum, P. vivax, and P. ovale) and every third day with the “quartan” parasite (P. malariae).

More commonly, the patient presents with a combination of the following symptoms:

  • Fever
  • Chills
  • Sweats
  • Headaches
  • Nausea and vomiting
  • Body aches
  • General malaise

In countries where cases of malaria are infrequent, these symptoms may be attributed to influenza, a cold, or other common infections, especially if malaria is not suspected.

What is the Treatment for Malaria?

In most cases, healthcare providers can successfully treat people with malaria. To decide which medicine to use, they should try to identify the species of parasite responsible and the geographical location where the person was infected.  Travelers to areas where malaria is endemic should take prophylactic medication during their period abroad. The CDC has extensive information on malaria advisories around the globe.

For more information, check out our casebook at

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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